Dengue
France
Since August this year, 7 clusters with a total of 36 local infections have been reported. In October, a local infection was recorded for the first time in the commune of Limeil-Brévannes (Val-de-Marne department, N). Bouches-du-Rhône (J), Alpes-Maritimes (SO), Pyrénées Orientales (J) and Drôme (SO) are affected. The first local infections were reported in France in 2010. The mosquito vector was first detected in the south of the country in 2004. Take care to protect against mosquitoes, which are mostly active during the day.
Smog
India
Air pollution is currently extremely high in New Delhi and the National Capital Territory (NCT) surrounding the national capital. At this time of year, the burning of crop residues in the surrounding fields regularly increases pollution, especially from fine dust. Young children, the elderly and people with chronic respiratory diseases are particularly at risk. It is recommended to stay indoors during peak exertion, avoid physical exertion and wear breathing masks if necessary. Travelers should closely monitor local media coverage.
Dengue
Italy
Since August this year, 30 local infections have been confirmed in the Lombardy (N) region. 28 other cases were recorded in the Lazio region (W), most of them in the metropolitan area of Rome. This is the first local infection in Italy since 2020. Based on an infection imported from Indonesia, a local cluster with at least 5 cases occurred in the Veneto region (N). The mosquito vector Aedes albopictus has been widespread in the country for several years. Take care to protect against day vector mosquitoes.
Dengue
Jamaica
Authorities declared an outbreak in late September. Around 1650 suspected cases and 370 confirmed infections have been reported this year. Pay attention to protection against mainly diurnal mosquito vectors. Vaccination is possible from February 2023.
Malaria
South Korea
After the country was declared malaria-free in 1979, local infections were reconfirmed in 1993. This year, around 660 local and around 60 imported diseases were registered by mid-October. Very good mosquito protection should always be maintained. Anyone who develops symptoms during or after a stay in the affected areas should seek medical attention immediately.
Tularemia
Sweden
Around 600 cases have been recorded so far this year, significantly more than usual at this time. Particularly affected are the provinces of Dalarna and Gävleborg in the centre and Västerbotten and Norrbotten in the north. The number of cases is now declining. Tularemia (rabbit plague) is a disease of wild animals, mainly rodents, common in the northern hemisphere. Transmission usually occurs through contact with animals and also blood-sucking insects and ticks. Almost exclusively people with relevant contacts, such as hunters, are at risk. Avoid contact with animals and also take precautions against mosquitoes and ticks.
intestinal infections
Egypt
Diarrhoeal disease risk nationwide. The Robert Koch Institute has reported an increase in enterohaemorrhagic Escherichia coli (EHEC) infections among returning travellers, particularly from Hurghada. Hepatitis A is also very common. Eating raw salads and undercooked foods should be avoided. Tap water should not be drunk. Observe food hygiene and vaccination protection.
Safety notice
Egypt
A warning is issued against travel to the north of the Sinai Peninsula, the Egyptian-Israeli border area (except Taba) and remote areas of the Sahara. Unaccompanied individual tours and overland trips to the south of the Sinai Peninsula are not recommended (www.auswaertiges-amt.de).
Monkeypox (Mpox)
Brazil
After several cases were confirmed in the UK in May 2022, other countries reported infections. Approximately 10 970 infections have been confirmed in Brazil. 16 people died. The virus is found in central and west Africa, and cases outside Africa have so far been traced to travellers or imported animals. Human-to-human transmission occurs through direct contact with the body fluids of an infected person or with objects contaminated with the virus.
Chikungunya
Brazil
Since the beginning of this year, around 218 615 suspected cases have been registered nationwide and around 99 270 infections have been confirmed. 78 people died. The number of cases has increased significantly compared to the same period last year. In 2022, a total of about 265,300 suspected cases were reported. 75 people died. In 2021, approximately 133,600 suspected cases were reported. 12 people died. In 2020, approximately 92,720 infections and 25 deaths were reported. Health authorities reported the first local infections in mid-2014. Since then, the infection has spread across the country. Pay attention to mosquito protection.
Dengue
Brazil
There is a high risk of dengue fever throughout the country. Since the beginning of this year, more than 2 570 000 suspected cases have been registered nationwide and 912 people have died. In the states of Espírito Santo (O) and Paraná (S), the number of cases increased compared to the same period last year. In 2022, approximately 2,363,500 illnesses and approximately 930 deaths were recorded. Take care to protect against mosquitoes, which are mostly diurnal. Vaccination is possible from February 2023.
intestinal infections
Dominican Republic
Diarrhoeal disease risk nationwide. The Dominican Republic is one of the holiday destinations with the highest number of cases of traveler’s diarrhea. As of October 2022, approximately 110 cholera infections have been reported. A man died. Most were registered in the capital, Santo Domingo. Take care of hygiene and consider vaccination if necessary.
Dengue
Dominican Republic
Around 12 000 suspected cases have been registered since the beginning of this year. 11 people died. Last year, around 10,440 suspected cases were reported. 42 people died. The number of cases roughly tripled in 2022 compared to the previous year. Particularly affected were the municipalities of Santiago, Santo Domingo de Guzmán, Santo Domingo Norte, Santo Domingo Este and San José de Ocoa. In 2021, approximately 3,750 infections and 26 deaths were registered. Pay attention to mosquito protection. Vaccination is possible from February 2023.
Input requirements
Dominican Republic
Dominican government since 15. September 2023 until further notice, completely closing the border with Haiti. Travel by land, air or sea between the two countries is currently not possible(www.auswaertiges-amt.de).
Safety notice
Greece
Since last week, there has been widespread flooding in the regions of Magnisia and Thessaly (especially in the areas around Volos, Trikala, Karditsa, Portaria, Larissa and the Pelion mountains, as well as on the island of Skiathos). There are extensive road closures. If you are affected by flooding, contact emergency numbers 112 and/or 199 immediately and do not leave the building. Evacuations by Greek emergency services are continuing – please communicate your location via the emergency numbers. Do not drink tap water in areas affected by flooding. It is important to avoid travelling to the above flood prone areas. Follow the warnings issued by the Greek Ministry of Civil Protection. Before you set off, find out about the risk situation at your destination; also contact your tour operator. If you are currently affected by evacuation measures, please contact your travel operator with questions about accommodation, meals, transport and, if necessary, the location of your luggage. Find out about the risk situation in the regions concerned and the recommendations for behaviour from the responsible authorities, the media and the National Weather Service. Always obey prohibitions, signs and warnings, as well as instructions from local authorities and security forces (www.auswaertiges-amt.de).
West Nile fever
Greece
Since mid-July, 160 infections and 20 deaths have been reported. The regions affected are Central Macedonia and Thessaly, as well as the island of Thasos. In Greece, the infection occurs sporadically. The virus is transmitted from one host to another by mosquitoes. It primarily infects birds, but can also spread to humans, horses and other mammals. Pay attention to mosquito protection.
Chikungunya
India
Approximately 3,711 cases have been reported nationwide since the beginning of this year. The worst affected states are again Maharashtra and Karnataka. Last year, approximately 8,070 cases were confirmed nationwide. The worst affected states were Karnataka, Maharashtra and Gujarat. Take care to protect yourself against the daily vectors of mosquitoes (Aedes species).
intestinal infections
India
Diarrhoeal disease risk nationwide. Cholera can be expected regionally. Typhoid, paratyphoid and orally transmitted forms of hepatitis are endemic throughout India. Anthrax occurs again and again in local people in both cutaneous and intestinal forms. Observe hygiene and vaccination protection.
Dengue
India
According to media reports, an increase in the number of cases was reported even after the monsoon ended. The highest number of cases were reported in the states of Delhi, West Bengal, Chattisgharh, Bihar, Uttar Pradesh, Telangana, Maharashtra, Punjab, Karnataka and Gujarat. In the capital New Delhi, around 5,220 people have fallen ill this year and one has died. For the whole of last year, there were 10,183 illnesses and 9 deaths. Due to heavy rains, the number of cases has increased in the state of Karnataka, where more than 9,180 cases have been recorded so far. Around 94,200 illnesses and 91 deaths were reported nationwide that year. Approximately 233,250 infections and 303 deaths were recorded in 2022. Take care to protect yourself against the daily vectors of mosquitoes (Aedes species). Vaccination is possible from February 2023.
encephalitis
India
By the end of September this year, approximately 830 cases of Japanese encephalitis (JE) had been officially reported nationwide. 48 people died. The state of Assam is particularly affected. In 2022, 1109 cases and 130 deaths were reported. The highest number of infections was again recorded in Assam state. Perform exposure prophylaxis and vaccination if necessary!
Malaria
India
By the end of July this year, around 86,765 cases had been registered nationwide and 21 people had died. The worst affected states are again Chhattisgarh and Urisa. Last year, approximately 174 000 cases and 68 deaths were reported. Very good protection against mosquitoes is always important, it is usually advisable to take emergency medication and depending on the outbreak, chemoprophylaxis should be discussed.
Nipah virus
India
Two people have died in Kozhikode district of Kerala (S) since the end of August. There are 4 other confirmed infections, those affected are being treated in hospital. Around 1,080 people who have had contact with infected people are being monitored. The Nipah virus was first discovered in Malaysia in 1998. The virus is found in the saliva and urine of infected bats. Transmission to humans occurs through the consumption of raw date juice; human-to-human transmission is also possible. The disease has flu-like symptoms with high fever and muscle aches and a general feeling of sickness. If the course is severe, inflammation of the meninges and brain occurs. Pay attention to food hygiene.
Safety notice
India
Travel to Jammu, Kashmir and Manipur is strongly discouraged at present. Always avoid demonstrations and large gatherings of people and follow the instructions of the security forces and keep up to date with media reports during your stay (www.auswaertiges-amt.de).
Smog
India
Air pollution is currently extremely high in New Delhi and the National Capital Territory (NCT) surrounding the national capital. At this time of year, the burning of crop residues in the surrounding fields regularly increases pollution, especially from fine dust. Young children, the elderly and people with chronic respiratory diseases are particularly at risk. It is recommended to stay indoors during peak exertion, avoid physical exertion and wear breathing masks if necessary. Travelers should closely monitor local media coverage.
Rabies
India
Deaths have been reported in several states this year. In late October/early July, 2 girls died after being bitten by a dog in Uttar Pradesh (N). In June, a 49-year-old woman who cared for stray dogs died in the state of Kerala (SW). In July, three young children were bitten by rabid dogs in the same condition and one died. India is one of the countries in the world with the highest number of animal and human cases. In total, around 310 people died last year. The most affected states are Karnataka, Maharashtra and West Bengal. The main transmitter is a (stray) dog. Large cities are also affected. In case of suspicious contact with an animal, seek medical attention immediately and pay attention to the use of modern vaccines for tissue culture. Preventive vaccinations are recommended for all passengers.
intestinal infections
Indonesia
Diarrhoeal disease risk nationwide. Cholera epidemics are reported sporadically in West Papua and typhoid fever can be expected. Continue to maintain hygiene and protection by vaccination against typhoid fever.
Leptospirosis
Indonesia
Authorities in the Sultanate of Yogyakarta on the island of Java have already recorded 64 cases this year. The number of cases has more than doubled compared to the previous year. The pathogen is shed by mammals (rats and dogs) and can enter humans through small skin lesions. In moist environments (water, mud), leptospires can survive in the environment for long periods of time. Adequate contact with wet habitats and inland waters should be avoided.
poliomyelitis
Indonesia
Since the end of January this year, 2 vaccine-derived poliovirus type 2 (cVDPV2) infections have been confirmed in Aceh province on the island of Sumatra. The child was already sick there last November. This is the first polio detection in the country since 2019. In March this year, the disease was confirmed in Java province. The emergence of the VDPV makes the country a country with a potential risk of international spread of the pathogen. As a result, all people (locals and tourists) who have been in the country for more than 4 weeks should be able to show proof of polio vaccination when leaving the country. Vaccinations must be given 4 weeks to one year prior to departure and must be documented on an internationally valid vaccination card.
Bird flu
Indonesia
Since November 2003, highly pathogenic avian influenza caused by influenza A(H5N1) has spread throughout the country with local and regional outbreaks in poultry. More than 10 million animals have fallen victim to animal disease so far. Since mid-2003, 200 human cases of the disease have been reported in Indonesia, of which 168 have been fatal. The last human infections were confirmed on the island of Bali in September 2017. Almost all of those affected had direct contact with sick or dead animals. Contact with live poultry or sick people should be avoided and hygiene should be maintained.
Ticks
Austria
In the warm season, there is a risk of tick-borne disease and, in much of the country, TBE, which can lead to encephalitis. Take care to protect against tick attachment. If you are in an infected area, vaccination may be recommended after an individual risk assessment.
Monkeypox (Mpox)
Spain
After several cases were confirmed in the UK in May 2022, other countries reported infections. Approximately 7 580 confirmed infections have been reported in Spain. 3 deaths have been confirmed. The virus is found in central and west Africa, and cases outside Africa have so far been traced to travellers or imported animals. Human-to-human transmission occurs through direct contact with the body fluids of an infected person or with objects contaminated with the virus.
West Nile fever
Spain
A total of 14 cases have been reported in 7 provinces this year. Two people died. The provinces of Huelva (SW), Valencia (O), Barcelona (O) and Cáceres are also affected for the first time. The infection is sporadic in Spain. The virus is transmitted from one host to another by mosquitoes. It primarily infects birds, but can also spread to humans, horses and other mammals. Pay attention to mosquito protection.
damn
South Africa
This year, around 1070 suspected cases have been registered, 199 infections have been confirmed and 47 people have died. In addition to Gauteng province, the Free State, Mpumalanga and Limpopo provinces are also affected. Take care of hygiene and consider vaccination if necessary.
measles
South Africa
In the past year, the number of cases has increased across the country. Approximately 1215 laboratory-confirmed infections have been reported since the beginning of October, with Limpopo, Mpumalanga, North West, Gauteng and Free State provinces particularly affected. The number of new infections is now declining. Always check and top up standard vaccination protection before travelling abroad.
Safety notice
South Africa
From 3. On August 2023, the shared taxi associations responsible for much of the local public transport in the Western Cape province, and particularly in the wider Cape Town area, are on strike. There have been sporadic clashes between security authorities and strikers, as well as attacks on bus companies. Some of them have ceased operations. There are isolated road closures in some parts of the city; airport access may also be affected. The electricity crisis continues with frequent and prolonged power cuts. These lead to temporary power outages, including in private accommodation, shops, banks and ATMs, public lighting, traffic lights and security systems. Power outages can also affect water supply and quality and continue to lead to restrictions on internet connectivity and mobile communications. Petrol stations may also be temporarily affected. For safety reasons, the South African National Park Authority advises travellers to avoid using the so-called “no-go” signs when entering Kruger National Park. Numbi gates and used alternative entry gates. To get to Addo Elephant Park from Port Elizabeth (Gqeberha), we recommend not using the R335 via Motherwell and alternatively use the N2 via Colchester (www.auswaertiges-amt.de).
Rabies
South Africa
This year 9 cases have already been confirmed, one in Limpopo province, 5 in KwaZulu-Natal and 3 in the Eastern Cape. Last year, 13 confirmed infections and 6 suspected cases were reported nationwide. The Eastern Cape, Limpopo and KwaZulu-Natal provinces were also particularly affected. Since last year, there has been a sharp increase in rabid dogs across the country. The most common source of infection is dog bites. If such contact occurs, seek medical attention immediately; if the risk is foreseeable and the stay is prolonged, preventive vaccination is recommended.
intestinal infections
Tanzania
Diarrhoeal disease risk nationwide. Localised outbreaks of cholera occur regularly. Take care with hygiene and consider vaccinations if necessary.
Requirement for initial vaccination
Tanzania
The risk of contracting yellow fever in Tanzania is classified by WHO as low and vaccination is generally not recommended. According to the official entry vaccination regulation (ITH 2020), yellow fever vaccination is mandatory for persons over 1 year of age when entering from endemic areas. Experience shows that regulations change frequently and the information provided by different authorities varies. The regulations are sometimes interpreted and dealt with differently at some airports (Kilimanjaro Airport in Arusha) or by individual border officials. Contrary to official information, a yellow fever vaccination is often required when entering Zanzibar. The official statement of the Zanzibar Ministry of Health is published on the website of the Federal Foreign Office.
poliomyelitis
Tanzania
The first vaccine-derived poliovirus type 2 (cVDPV2) infection was reported in July this year. The second infection was reported in early September. Due to the presence of cVDPV2, the country is formally classified as a country with a potential risk of international spread of the pathogen. As a result, all people (locals and tourists) who stay in the country for more than 4 weeks must present a polio vaccination when they leave the country. Vaccinations must be given 4 weeks to one year prior to departure and must be documented on an internationally valid vaccination card. Observe protection by vaccination.
Chikungunya
Thailand
Around 820 infections have been confirmed so far this year. Compared to 2021, the number of cases doubled last year, with a total of around 1,400 infections reported from 48 provinces. In 2021, around 670 cases were registered nationwide. Pay attention to mosquito protection.
intestinal infections
Thailand
Risk of diarrhoeal diseases nationwide, smaller cholera outbreaks can be expected locally. Take care of hygiene.
Dengue
Thailand
Since the beginning of this year, around 110,810 infections and 107 deaths have been reported. Trat, Nan, Chanthaburi, Rayong and Mae Hong Son provinces are particularly affected, as well as the capital Bangkok. Take care to protect yourself against daytime mosquitoes. Vaccination is possible from February 2023.
Monkeypox (Mpox)
USA
After several cases were confirmed in the UK in May 2022, other countries reported infections. In the United States, approximately 30,860 infections have been reported in all 50 states and Washington, D.C. as well as those registered in Puerto Rico. 54 people died. In early August 2022, the government declared a national health emergency. The virus is found in central and west Africa, and cases outside Africa have so far been traced to travellers or imported animals. Human-to-human transmission occurs through direct contact with the body fluids of an infected person or with objects contaminated with the virus.
Dengue
USA
There have been 68 confirmed local infections in the state of Florida this year. Miami-Dade, Broward, Palm Beach, Hardee and Polk counties are affected. The first case was reported in early February. Last year, 68 cases were recorded. Take care to protect yourself against daytime mosquitoes. Vaccination is possible from February 2023.
Hepatitis A
USA
According to the CDC, there has been an increase in nationwide outbreaks since 2016, with infections spreading from person to person. Those affected are mainly homeless and addicted people. Approximately 44,910 infections and 423 deaths have now been reported from 37 countries. Most infections were reported in the states of Kentucky, Florida, Ohio, Tennessee, Georgia, Alabama and Indiana. Pay careful attention to hygiene measures and consider vaccinations if necessary.
Malaria
USA
Earlier this October, Arkansas state health officials confirmed a local infection in Saline County. In mid-August, the first local case of tropical malaria in the state of Maryland in more than 40 years was reported in the Washington metropolitan area. In mid-June this year, health authorities in the state of Texas confirmed a local infection (malaria tertiana) in Cameron County. For the first time in 20 years, 7 locally acquired cases of tertian malaria have been confirmed in the state of Florida since May. Authorities are warning of mosquito-borne diseases in Florida. Malaria is very rare in the USA, the last time 8 local cases of tertian malaria were reported in Palm Beach County (Florida) in 2003. Pay extra attention to mosquito repellent.
poliomyelitis
USA
At the end of June 2022, poliovirus infection derived from the type 2 vaccine (cVDPV2) was confirmed in the US for the first time since 2013. The 20-year-old was temporarily treated at a paralysis clinic in Rockland County (New York State). Authorities say polioviruses were detected in wastewater samples in the county before the man became ill. By the end of March this year, viruses had been detected in more than 100 wastewater samples, and New York State authorities declared a disaster in early September. Residents were asked to check their vaccination protection and top up if necessary. Always check and top up standard vaccination protection before travelling abroad.
sun protection
USA
Starting in early 2021, the sale of so-called reef-toxic sunscreens, including products that contain oxybenzone (BP3) and octinoxate, is banned in the state of Hawaii. These substances are suspected of having a harmful effect on corals and other marine life.
West Nile fever
USA
This year, by mid-October, 1,936 infections and at least 20 deaths had been reported nationwide, with the states of Colorado, Arizona, California and Nebraska particularly affected. The peak season is from July to October, but transmission is possible all year round. Pay attention to mosquito protection.
intestinal infections
Vietnam
Diarrhoeal disease risk nationwide, cholera is also endemic. Take care of food and drinking water hygiene.
Dengue
Vietnam
Since the beginning of this year, approximately 87 720 infections and 24 deaths have been reported. The number of cases in Hanoi and Ho Chi Minh City has increased unusually since July. Last year, around 367,730 illnesses and 140 deaths were recorded. The number of cases was about 5 times higher than in 2021. Regions in the south and centre of the country, as well as Ho Chi Minh City, were particularly affected. In 2021, around 68,270 cases were reported and 21 people died. Take care to protect against mosquitoes, which are mostly diurnal. Vaccination is possible from February 2023.
Bird flu
Vietnam
After a gap of more than 8 years, a 5-year-old girl fell ill with H5 influenza virus infection in October 2022. She ate meat from sick chickens and ducks. Between 2003 and 2014, a total of 127 people fell ill with influenza A (H5N1) across the country and 64 died. In all affected individuals, adequate animal contacts could be demonstrated. Since 2014, numerous outbreaks in domestic poultry have been reported across the country with more than 129,000 animals killed. At the end of May this year, there was an outbreak in Quang Ngai province with about 1700 sick ducks. Vaccination of poultry is widespread in the country. Outbreaks of influenza A(H5N6) have been repeatedly reported in poultry farms since 2014. Since the beginning of 2021, 3 outbreaks have already been reported in 2 provinces. No human illnesses have occurred so far.
SOURCE/SOURCE: https://crm.de/aktuelles/